INEQUITY IN MATERNAL AND CHILD HEALTH CARE UTILISATION IN NIGERIA

ABSTRACT

The high maternal and child mortality rates of 500 per 100,000 and 128 per 1,000 live births are major research and health policy concerns often caused by inequity in utilisation of basic maternal and child healthcare in Nigeria. Although existing literature provided estimates of determinants of maternal and child healthcare utilisation, inequity in maternal and child healthcare utilisation has not been given adequate attention. This study, therefore, examined horizontal inequity in maternal and child health care utilisation in Nigeria.

Social welfare and demand theories of healthcare utilisation were adopted. Concentration curves and standardised concentration index were used to analyse need variables (age and pregnancy status) and non-need variables (education and wealth) in the estimation of horizontal inequity in maternal and child health care utilisation. Maternal healthcare status was measured by antenatal attendance and delivery by skilled personnel, while child healthcare status was measured by immunisation experience and bednets usage. Two-part models (logit, negative binomial), logit and multinomial logit were used to estimate determinants of antenatal care, skilled delivery, immunisation and bednets utilisation, respectively. Data were derived from five sets of Nigeria Demographic and Health Survey (NDHS). The survey covered 8,781, 8,918, 2,572, 34,596 and 39,902 women aged 15-49 for 1990, 1999, 2003, 2008 and 2013, respectively. Data were analysed at p